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Alison Crosbie

Objective

Asthma is a leading cause of chronic illness in children, impacting heavily on their daily life and participation in physical activity. The purpose of this systematic review was to investigate the evidence for the use of physical therapy to improve pulmonary function and aerobic capacity in children with asthma. Furthermore, the review aims to update previous literature on the effect of exercise on health related quality of life.

Methods

A search was conducted for randomized control trials (RCTs) using the electronic databases Medline, Embase, SPORTDiscus, AMED, CINAHL, and The Cochrane Central Register of Controlled Trials. Studies were included if the participants were asthmatic children aged 6–18 years participating in any mode of physical exercise. Studies were reviewed for study quality, participant details, exercise intervention details, and intervention outcomes.

Results

A total of 16 studies and 516 subjects met inclusion criteria for review. Severity of asthma ranged from mild to severe. No improvement in pulmonary function was observed. Physical training led to an increase in aerobic capacity as measured by VO2max (mL/kg/min).

Conclusions

Findings suggest that physical training does not improve pulmonary function in children with asthma, but does increase aerobic capacity. The small number of studies investigating quality of life suggests that physical training does improve health related quality of life; however further well designed randomized control trials are needed to verify these findings.

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Franciele Cascaes da Silva, Rodrigo da Rosa Iop, Patrícia Domingos dos Santos, Lídia Mara Aguiar Bezerra de Melo, Paulo José Barbosa Gutierres Filho and Rudney da Silva

This study aimed to determine the effects of physical-exercise-based rehabilitation programs on quality of life of patients with Parkinson’s disease through a systematic review of randomized clinical trials. For this purpose the following electronic databases were selected: Medline by PubMed, Cochrane, Web of Science, and PEDro. The search strategy included the proposed descriptors in the Medical Subject Headings (MeSH), associated with a sensitive list of terms to search for randomized controlled trials (RCTs), without year and language restrictions. Fourteen studies were potentially relevant, and these studies were included. Physical-exercise-based rehabilitation programs realized 2–4 times a week, 60 min each session, for 6–12 weeks, and follow-up of 3 months promotes significant positive effects on quality of life in Parkinson’s disease patients at mild to moderate stages and disease duration around 6 years.

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Katja Linde and Dorothee Alfermann

Background:

Physical and cognitive activity seems to be an effective strategy by which to promote age-sensitive fluid cognitive abilities in older adults.

Method:

In this randomized controlled trial, 70 healthy senior citizens (age 60–75) were allocated to a physical, cognitive, combined physical plus cognitive, and waiting control group. The trial assessed information processing speed, short-term memory, spatial relations, concentration, reasoning, and cognitive speed.

Results:

In contrast to the control group, the physical, cognitive, and combined training groups enhanced their concentration immediately after intervention. Only the physical training group showed improved concentration 3 months later. The combined training group displayed improved cognitive speed both immediately and three months after intervention. The cognitive training group displayed improved cognitive speed 3 months after intervention.

Conclusions:

Physical, cognitive, and combined physical plus cognitive activity can be seen as cognition-enrichment behaviors in healthy older adults that show different rather than equal intervention effects.

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Leena Hakola, Kai Savonen, Pirjo Komulainen, Maija Hassinen, Rainer Rauramaa and Timo A. Lakka

Background:

Little is known about factors that modify the effectiveness of exercise interventions in increasing exercise. We aimed to identify moderators of the effectiveness of aerobic exercise intervention in maintaining increased aerobic exercise among older individuals.

Methods:

The participants of a 4-year randomized controlled trial were a population sample of 1410 men and women aged 57 to 78 years. The aerobic exercise group included 185 individuals and the control group included 169 individuals who reported low aerobic exercise at baseline. Maintained increase in aerobic exercise was defined as at least 60-minute increase in moderate-to-heavy aerobic exercise per week from baseline to 2- and 4-year assessments.

Results:

Individuals in the aerobic exercise group were 2.5 (95% CI 1.5 to 3.9) times more likely to maintain increased aerobic exercise than those in the control group. Individuals aged < 68.5 years but not older individuals succeeded in maintaining increased aerobic exercise in the intervention group (P = .02 for interaction). Individuals who were past smokers (P = .02 for interaction), were working (P = .05 for interaction), or had symptoms of depression (P = .05 for interaction) succeeded better in maintaining increased aerobic exercise in the intervention group than other individuals.

Conclusions:

These findings help in more precise targeting of future exercise interventions among older individuals.

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Antonio García-Hermoso, Mairena Sánchez-López and Vicente Martínez-Vizcaíno

The purpose of this meta-analysis of randomized trials was to determine the effectiveness of aerobic plus resistance exercise interventions on body composition related to variables in overweight and obese youth. A computerized search was made of 7 databases. The analysis was restricted to randomized controlled trials that examined the effect of aerobic and resistance exercise on body composition (body weight, body mass index, fat mass, fat-free mass, and waist circumference) in obese youth. Two independent reviewers screened studies and extracted data. Weighted mean differences (WMD) and 95% confidence intervals were calculated. Nine studies were selected for meta-analysis as they fulfilled the inclusion criteria (n = 365). Aerobic plus resistance exercise interventions (8–24 weeks duration) produced a decrease in body weight (WMD=-3.31 kg), body mass index (WMD=-1.05 kg/m2), and fat mass (WMD=-1.93% and 5.05 kg), but changes in fatfree mass and waist circumference were not observed. These changes were accentuated through programs of at least 60 min of exercise per session, generating greater reductions in body weight (WMD=-4.11 kg), fat mass (WMD=-4.07%), and increase in fat-free mass (WMD = 2.45 kg). This meta-analysis provides insight into the effectiveness of short-term aerobic plus resistance exercise interventions for decreasing body weight, body mass index, and fat mass in pediatric obesity.

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Rosemarie Martin and Elaine Murtagh

Background:

A cluster randomized controlled trial was conducted to assess the effectiveness of the Active Classrooms intervention, which integrates movement into academic lessons, on the moderate-to-vigorous physical activity levels (MVPA) of primary school children during class-time and throughout the school day.

Methods:

Ten classroom teachers and their students aged 8 to 12 years were recruited and randomized into the Active Classrooms intervention group (n = 131students, n = 5teachers) or a delayed-treatment controlled group (n = 117students, n = 5teachers). The intervention group participated in active academic lessons taught by the classroom teacher over an 8 week period. Accelerometers were used to gather physical activity data at baseline, postintervention and at 4 months follow-up. Teachers completed a questionnaire to evaluate the program.

Results:

A significant difference for change in daily class time MVPA levels was identified between the treatment (n = 95) and control (n = 91) groups from pre- to postintervention (P < .001) and this difference was maintained at follow-up (P < .001). No significant difference emerged between the treatment and control groups for change in school day MVPA levels from pre- to postintervention (P = .52) or follow-up (P = .09). Teachers reported that they were highly satisfied with the program.

Conclusions:

Movement integration has the potential to improve physical activity levels of primary school children in the classroom.

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Cadeyrn J. Gaskin, Melinda Craike, Mohammadreza Mohebbi, Kerry S. Courneya and Patricia M. Livingston

Background:

The ENGAGE (efficacy of a referral and physical activity program for survivors of prostate cancer) study established that a clinician referral and 12-week exercise training program increased vigorous physical activity at 12 weeks among men with prostate cancer. Here, we report the 6- and 12-month outcomes.

Methods:

In this multicenter cluster randomized controlled trial, we compared a clinician referral and exercise training program to usual care. Discounted gym membership was offered to men in the intervention condition on completion of the 12-week exercise program. Self-reported physical activity at 6 and 12 months was the primary outcome. Quality of life, anxiety, and depressive symptoms were secondary outcomes.

Results:

A total of 147 men meeting eligibility criteria agreed to participate (54 intervention, 93 control). A positive interaction effect for vigorous physical activity was observed at 6 months, but not 12 months. No significant effects for the secondary outcomes were found.

Conclusions:

A clinician referral and community-based supervised and unsupervised exercise training program, along with discounted gym membership, had a positive short-term effect on vigorous physical activity levels, but did not improve quality of life, in men with prostate cancer.

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Mercedes Vélez-Toral, Débora Godoy-Izquierdo, Nicolás Mendoza Ladrón de Guevara, Carlos de Teresa Galván, Alberto Salamanca Ballesteros and Juan F. Godoy García

Background:

This study explored multidimensional outcomes that were derived from the adherence to regular exercise among previously sedentary postmenopausal 45 to 64 years old women who engaged in a ~20-week exercise program.

Methods:

A randomized controlled trial with between-group (intervention and control women) and within-subject measures (baseline, postintervention, and 3-month and 12-month follow-ups) was conducted. HRQoL and several indicators of cardio-metabolic status and fitness were assessed.

Results:

After the intervention, the participants experienced a positive change in their short and long-term physical and mental health, with significant enhancements in several HRQoL dimensions, particularly mental well-being (23.3% of change) and menopause-related health and subdomains (17.0% of change) (P < .01). Improvements were maintained or continued (eg, mental well-being) overtime. These outcomes were accompanied by significant improvements in cardio-metabolic status and fitness, including weight, BMI, cardio-respiratory fitness and flexibility (up to 16.2% of change, P < .05). After the intervention, the intervention group exhibited better HRQoL than the control group at each of the measurement phases. Between-group differences were also observed for some indicators of cardiovascular health and flexibility.

Conclusions:

Our findings add evidence on the association of positive outcomes on HRQoL with improvements in cardio-metabolic health and fitness status after the adoption of an active lifestyle.

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Hadas Gabizon, Yan Press, Ilia Volkov and Itshak Melzer

Objectives:

To evaluate the effect of a group-based Pilates training program on balance control and health status in healthy older adults.

Design:

A single-blind, randomized, controlled trial.

Setting:

General community.

Participants:

A total of 88 community-dwelling older adults (age 71.15 ± 4.30 years), without evidence of functional balance impairment, were recruited and allocated at random to a Pilates intervention group (n = 44) or a control group (n = 44).

Intervention:

The Pilates intervention group received 36 training sessions over three months (3 sessions a week), while the control group did not receive any intervention.

Outcome measures:

Standing upright postural stability, performance-based measures of balance, and self-reported health status was assessed in both groups at baseline and at the end of the intervention period.

Results:

Compared with the control group, the Pilates intervention did not improve postural stability, baseline functional measures of balance, or health status.

Conclusions:

The results suggest that because Pilates training is not task specific, it does not improve balance control or balance function in independent older adults.

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Daniel L. Borges, Mayara Gabrielle Silva, Luan Nascimento Silva, João Vyctor Fortes, Erika Thalita Costa, Rebeca Pessoa Assunção, Carlos Magno Lima, Vinícius José da Silva Nina, Mário Bernardo-Filho and Danúbia Sá Caputo

Background:

Physical activity is beneficial in several clinical situations and recommended for patients with ischemic heart disease, as well as for those undergoing cardiac surgery.

Methods:

In a randomized controlled trial, 34 patients underwent coronary artery bypass grafting. A randomized control group (n = 15) submitted to conventional physiotherapy. The intervention group (n = 19) received the same protocol plus additional aerobic exercise with cycle ergometer. Pulmonary function by spirometry, respiratory muscle strength by manovacuometry, and functional capacity through 6-minute walking test was assessed before surgery and at hospital discharge.

Results:

There was significant reduction in pulmonary function in both groups. In both groups, inspiratory muscle strength was maintained while expiratory muscle strength significantly decreased. Functional capacity was maintained in the intervention group (364.5 [324.5 to 428] vs. 348 [300.7 to 413.7] meters, P = .06), but it decreased significantly in control group patients (320 [288.5 to 393.0] vs. 292 [237.0 to 336.0] meters, P = .01). A significant difference in functional capacity was also found in intergroup analyses at hospital discharge (P = .03).

Conclusion:

Aerobic exercise applied early on coronary artery bypass grafting patients may promote maintenance of functional capacity, with no impact on pulmonary function and respiratory muscle strength when compared with conventional physiotherapy.